Weight Loss Surgery Weight Loss Surgery 4 — Questions and Answers
Question 1: Which of the following is a CONTRAINDICATION to bariatric surgery?
- BMI of 38 with type 2 diabetes
- Active and untreated substance use disorder (Correct answer)
- History of depression that is currently controlled
- Age over 50
Correct answer: Active and untreated substance use disorder
Active substance use disorder is a contraindication because it significantly worsens surgical and psychological outcomes and must be resolved before surgery.
Question 2: What is the expected average excess weight loss percentage at 1 year after Roux-en-Y gastric bypass?
- 20-30%
- 35-45%
- 60-80% (Correct answer)
- 85-95%
Correct answer: 60-80%
Roux-en-Y gastric bypass typically results in 60-80% excess body weight loss within the first year.
Question 3: A bariatric patient develops tingling in hands and feet, difficulty walking, and megaloblastic anemia 18 months post-bypass. Which deficiency is most likely?
- Vitamin D deficiency
- Zinc deficiency
- Vitamin B12 deficiency (Correct answer)
- Folate deficiency
Correct answer: Vitamin B12 deficiency
B12 deficiency causes subacute combined degeneration of the spinal cord, presenting with peripheral neuropathy and megaloblastic anemia.
Question 4: What is 'weight recidivism' in bariatric surgery outcomes?
- The regaining of lost weight after initial surgical success (Correct answer)
- The failure to lose any weight after bariatric surgery
- A complication requiring surgical revision
- The plateau phase occurring at 6 months post-surgery
Correct answer: The regaining of lost weight after initial surgical success
Weight recidivism refers to the regaining of previously lost weight, which can occur due to behavioral, anatomical, or hormonal changes.
Question 5: Which micronutrient supplement is universally recommended for ALL bariatric surgery patients regardless of procedure type?
- Omega-3 fatty acids
- Multivitamin with minerals (Correct answer)
- Probiotics
- Magnesium citrate
Correct answer: Multivitamin with minerals
A comprehensive multivitamin with minerals is recommended lifelong for all bariatric patients to prevent nutrient deficiencies from reduced food intake.
Question 6: What is 'internal hernia' and why is it specifically associated with Roux-en-Y gastric bypass?
- Hernia through the abdominal wall at trocar sites
- Bowel herniation through mesenteric defects created during the bypass (Correct answer)
- Esophageal hiatal hernia worsened by surgery
- Hernia of the gastric pouch through the diaphragm
Correct answer: Bowel herniation through mesenteric defects created during the bypass
Bypass surgery creates mesenteric spaces (Peterson's space, transverse mesenteric defect) through which loops of bowel can herniate.
Question 7: What dietary behavior is MOST important for bariatric patients to practice to avoid stretching the gastric pouch?
- Drinking large amounts of water with meals
- Eating slowly and stopping at the first sign of fullness (Correct answer)
- Avoiding all solid foods for 6 months
- Taking digestive enzyme supplements before meals
Correct answer: Eating slowly and stopping at the first sign of fullness
Eating slowly and recognizing satiety signals prevents overeating that gradually stretches the pouch, reducing restriction over time.
Weight Loss Surgery Weight Loss Surgery 4
Which of the following is a CONTRAINDICATION to bariatric surgery?